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Christian Sinclair, MD, National Medical Director at Gentiva Health Services in Kansas City, is a prolific presence on social media, serving as co-editor of Pallimed, a Hospice & Palliative Medicine Blog; running the @ctsinclair and @pallimed Twitter accounts; and managing the Facebook pages for Pallimed and National Hospice and Palliative Care Month.

He said he used to advocate that all medical professionals join in the online conversation, but he has now come to embrace wallflowers: “Listening can be just as important as creating content. I encourage health care professionals who are skeptical of social media to go to some of the platforms and see what people are saying about your specialty. For example, if you are a colon cancer specialist, search ‘colon cancer’ on Twitter or Pinterest. You will get insight into different ways to look at your specialty.”

Where do you listen?

“Facebook and Twitter are the two main platforms I use, but I also like YouTube, Pinterest, Google Plus, and LinkedIn. There is lots of activity going on there that is definitely relevant to health care in general, but also is important to the hospice and palliative care field.

“Each platform offers something different. For example, there's not necessarily a lot of health care professional content on Pinterest, although there is some. The Pinterest demographic skews heavily female, and females are the biggest part of the caregiving population, so if you look on Pinterest for caregiving links, there are a lot of people who have cultivated important links. I learn from that to help share with my patients and my families so I can say, ‘These are things that I'm hearing that are important to other caregivers. You might find this helpful, too.’

“The other thing I see on Pinterest are quotes of inspiration for caregivers that really speak to what I see in a clinical setting. Caregivers who are dealing with a lot of challenges in caring for their loved one are looking for things that help reframe their view on life. When there are really down, hard days, what can help me look at this in a different light? On Pinterest, I find many affirmations of the important role of a caregiver, and the love and the support that being a caregiver brings. I like to see that because it's a glimpse into the feeling of a group that typically doesn't have a voice.

“The other group I have learned a lot about on Pinterest is people who volunteer. If you search on Pinterest for ‘hospice,’ you see a lot of people put pins up that say something like, ‘I want to volunteer for hospice,’ or ‘I do volunteer for hospice,’ and that helps me understand what's important to people in that group.

“What is it about volunteering for hospice that gives them a sense of community? If we in the health care field really want to be responsive to what our community is asking of us, it does pay for us to engage in and listen on those platforms where people are telling us openly.”

How about LinkedIn—how do you use that?

“That content is a lot more on the business side of health care. For example, there might be posts about a new conference, a hospice closing, or new regulations. Then you have people in administrative or executive positions talking about the implications, and those sort of conversations are important to hear before they ever hit the e-mail inbox.”

What are you trying to achieve with your Twitter and Facebook accounts?

“It's one thing to go on social media platforms and just explore and look around and learn, but if you are going to actively participate, it is important to have some goals and some strategies in mind. You're not going to come up with them right away. You have to learn the syntax and the culture of those platforms, because each one is different, but once you get a sense of how they work, it is good to think about what you want to achieve. That helps you make better use of your time, because social media sites can steal a lot of your time if you're not focused on your goals.

“My first goal is to engage advocates for hospice and palliative medicine, and the other goal is to stimulate conversations. The first one is where it's a lot easier to succeed. Once you have enough people who like your page, they start to like and share and spread that information.

“Hospice and palliative medicine does not have a large budget to spend on TV and radio advertising and billboards. But an actively engaged base on a fan page will share and like and send information out to their networks for you, and that's an important way to spread good information.”

Any tips for engaging an audience?

“In the early days of the Pallimed's fan page, I just posted everything from the Pallimed website to the Facebook page. But now I go to other pages such as the Hospice and Palliative Nurses Association Facebook page and share something from their sites. So just by calling them out as having an interesting story, that informs advocates that the association exists and also shares the good story that they had posted.

“In the past year I have also started to experiment with Facebook advertising. For example, when I posted something about how critical chaplains are to really good palliative care, I spent $10 for 24 hours and targeted that story to some 3,000 people who had self-identified as being interested in chaplain-related stories by ‘liking’ chaplain pages on Facebook. By only spending a few dollars, I can get a lot more people who now see that story and then spread that to other people who likely have similar interests.”

How would you like to see social media related to oncology evolve?

“The oncology presence on social media has really grown in the past couple years, and I'm glad to see that. But when it comes to cancer, a lot of social media content is about the pink ribbon and ‘I'm fighting this cancer’ and maybe ‘Let's raise some money.’ That is important, but as far as talking about the nitty-gritty of everyday medical care for cancer, I don't see much out there.

“That is a little bit scarier, a little bit tougher. There are patients who write about this often, but I'm not seeing a high level of social media engagement from clinicians on the more challenging aspects of cancer care. Some people are doing it certainly, but for as big of a field as oncology is, there is a lot more room to participate and get really good information about the tough challenges that oncology faces in providing good health care to people.”

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